Acetaminophen, Aspirin, and NSAIDs

Acetaminophen

Acetaminophen is a safe and effective pain reliever for mild pain. This drug can be combined with an NSAID or an opioid to provide more effective pain relief for cases of moderate or severe pain. Known commercially under such names as Tylenol® and Tempra®, acetaminophen is often used for toothaches, pain from ear infections, and headaches, as well as for treating fevers.

Every drug store carries its own brand name of acetaminophen, and this is usually a cheaper though equally effective and safe form than that produced under brand names. These medicines are safe for infants and children when individual and daily dose limits are followed, and they come in liquid, suppository, and tablet forms.

Acetaminophen is also available in combined form with different amounts of codeine​ and other pain medicines such as oxycodone. Such combined forms are suitable for the relief of moderate pain. Depending on the amount of codeine​ contained in the drug, a prescription may be required for this medicine. A common name in Canada for these "mixed drugs" are Tylenol® with the added numbers #1, #2, and #3. These numbers indicate the amount of codeine in each tablet; #1 being the smallest amount added and #3 being the largest. Codeine is described on the "Opioids​" page of this site.

NSAIDs

NSAIDs, or non-steroidal anti-inflammatory drugs, are a class of drugs that can be very effective in reducing pain. This is especially so when inflammation – usually indicated by redness, swelling, or heat – is playing a part in producing the pain. The most common type of NSAID is ibuprofen. It is commonly known in Canada as Advil® or Motrin®. However, generic ibuprofen is just as effective as these brand name medicines and costs less.

NSAIDs are commonly used for headaches, toothache, muscular aches, and menstrual cramps, and may also be used to reduce fever. They may be combined with acetaminophen and opioids more effectively to manage pain due to surgery and to treat some chronic pain conditions.

Ibuprofen is available at the drugstore over the counter without a prescription. However, other NSAIDs, such as naproxen, diclofenac, meloxicam, and celecoxib are available only by prescription.

Aspirin or ASA

Acetylsalicylic acid​ (ASA)​​ or Aspirin® is also an NSAID but is less safe than ibuprofen and should not be used by children under the age of 16 years because of the risk of developing Reye’s syndrome which can cause liver and brain damage. Reye’s syndrome is rare and is thought to afflict children who have a viral illness, such as flu, and who take aspirin at the same time.

Side effects

One of the most common side effects of NSAIDs is stomach upset. Usually, this can be avoided by making sure the correct dose is taken and by taking the medicine with food. Eating some crackers or drinking milk just before the medicine is taken is usually enough to avoid a stomach upset. In very rare cases, NSAIDs can cause bleeding problems and their use may need to be stopped before surgery. It is important to let your doctor know if your child has a bleeding disorder, asthma, kidney problems, or is undergoing chemotherapy, or has ever had a stomach ulcer before using NSAIDs.